title: [How practical guidelines can be applied in poor countries? Example of the introduction of a bronchoscopy unit in Cambodia].
abstract: According to UN, Cambodia is one of the poorest countries in the World. Respiratory diseases are current public health priorities. In this context, a new bronchoscopy unit (BSU) was created in the respiratory medicine department of Preah Kossamak hospital (PKH) thanks to a tight cooperation between a French and a Cambodian team. Aim of this study was to describe conditions of introduction of this equipment. Two guidelines for practice are available. They are respectively edited by the French and British societies of pulmonology. These guidelines were reviewed and compared to the conditions in which BS was introduced in PKH. Each item from guidelines was combined to a categorical value: "applied", "adapted" or "not applied". In 2009, 54 bronchoscopies were performed in PKH, mainly for suspicion of infectious or tumour disease. In total, 52% and 46% of the French and British guideline items respectively were followed in this Cambodian unit. Patient safety items are those highly followed. By contrast "staff safety" items were those weakly applied. Implementation of EBS in developing countries seems feasible in good conditions of quality and safety for patients. However, some recommendations cannot be applied due to local conditions.
authors.affiliation: Service de pneumologie, hospices civils de Lyon, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; Faculté de médecine et de maïeutique Lyon Sud-Charles-Mérieux, université Lyon-1, 69600 Oullins, France; Association Prupet, 69007 Lyon, France. Electronic address: scouraud@yahoo.fr.
authors.forename: S
authors.initials: S
authors.lastname: Couraud
authors.forename: S
authors.initials: S
authors.lastname: Chan
authors.forename: V
authors.initials: V
authors.lastname: Avrillon
authors.forename: K
authors.initials: K
authors.lastname: Horn
authors.forename: S
authors.initials: S
authors.lastname: Try
authors.forename: L
authors.initials: L
authors.lastname: Gérinière
authors.forename: É
authors.initials: É
authors.lastname: Perrot
authors.forename: C
authors.initials: C
authors.lastname: Guichon
authors.forename: P-J
authors.initials: PJ
authors.lastname: Souquet
authors.forename: C
authors.initials: C
authors.lastname: Ny
mesh_terms: D001999:Bronchoscopy / Q000009:adverse effects / Q000592:standards*; D002160:Cambodia; D003666:Decontamination / Q000592:standards; D003906:Developing Countries / Q000191:economics; D005260:Female; D019983:Guideline Adherence / Q000191:economics / Q000706:statistics & numerical data; D006284:Health Plan Implementation / Q000191:economics / Q000592:standards; D006757:Hospital Units / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061214:Patient Safety / Q000592:standards; D011203:Poverty; D017410:Practice Guidelines as Topic
keywords: Bronchoscopy; Cambodge; Cambodia; Coopération; Endoscopie bronchique; Guidelines; Pays en voie de développement; Pneumologie; Poor countries; Respiratory medicine